Failure To Diagnose

Headaches are a common symptom of many conditions and almost everyone will experience headaches at some point in their lives. Normally the average headache is nothing to worry about, despite the discomfort you might be experiencing. However, if you get a severe/sudden headache unlike any you have had before, you should always seek medical advice. Sometimes, a headache can be a warning of something serious that needs to be investigated so don’t delay in seeking help.

As I have a long history of chronic sinus infection, I’m well-used to getting headaches. I don’t panic when a headache occurs as I’m familiar with the signs and symptoms of acute sinusitis and have the necessary prescription medications to relieve the pain. However, if I develop a severe headache that I’m not familiar with/it continues to worsen, I will always seek medical advice. If the headache is considered a cause for concern, my GP/specialist will refer me for an urgent CT/MRI scan in order to rule out any serious cause. As I hold private health insurance, I rarely have to wait longer than 24 hours to undergo a scan. If, however, I had no health insurance and was a patient in the public health service, the story could be very different…

THE HSE has apologised before the High Court to the family of a young woman over deficiencies and failures which led to her death from a massive brain haemorrhage. The apology was part of a settlement of court proceedings.

“Louise Butler (21), Cappa Lodge, Sixmilebridge, Co Clare, died at Limerick Regional Hospital on November 16th, 2006, from a large subarachnoid haemorrhage, the court heard. She had worked as a security guard at Shannon airport.

Her family claimed the HSE had failed to properly diagnose she was suffering from the condition when she presented at the hospital just weeks earlier suffering with a serious headache.

Had she been properly diagnosed and referred for treatment after being admitted on October 6th, she would probably have survived, they alleged.

As part of the settlement yesterday of the family’s action for mental distress, the HSE apologised for the anguish and distress caused to the Butlers due to Louise’s tragic death.

The HSE also acknowledged there were failures and deficiencies which led to Ms Butler’s death and accepted her family did everything it could in the circumstances.

The settlement also includes a payment of €40,000 to Ms Butler’s family and was approved yesterday by Mr Justice Michael Peart. The action was brought by her brother James, Cappa Lodge, Sixmilebridge on behalf of the family.

They claimed they suffered mental distress and injury arising from their older sister’s death due to the HSE’s alleged negligence and breach of duty of care. The HSE had denied the claims.

The family claimed Ms Butler’s attended the hospital between October 6th-12th. It was claimed she was ill with a very substantial headache, which she had described as like “a hammer blow” to the back of her head, and photophobia.

She was discharged on October 12th without a CT scan being carried out. She was due to have a CT scan subsequently as an outpatient.

Despite the best endeavours of Ms Butler’s mother and the family GP it was claimed the scan was not arranged until November 13th. It was claimed Ms Butler never got the results of that scan as she collapsed the following day. The scan revealed she suffered a massive bleed in the brain and she died two days later.

It was alleged the HSE had delayed a CT scan which would have alerted medical staff to the existence of her condition. The family claimed their experts would argue, in October 2006, Ms Butler was suffering from a “sentinel” or “herald” bleed, which was a precursor to a large bleed.”

Information Source: The Irish Times 13/07/10

The Silent Killer

Last Christmas morning, the Hughes family from Co Mayo suffered the most terrible of tragedies. Padraig Hughes (20) died in his sleep from inhaling toxic carbon monoxide fumes from a leaking gas boiler.  His twin sister, Emma, narrowly survived.

“IT would be hard for any parent to imagine a more hellish Christmas morning – going to wake your precious children and not being able to. Slowly realising they are in serious trouble. Being unable to make contact with the emergency services. And it dawning on you – too late – that a €60 alarm could have prevented the whole tragedy.”

Carbon Monoxide (CO) is highly dangerous. You can’t see it or smell it. In fact it is often called “the silent killer”. It is thought to be responsible for about 40 deaths in Ireland each year. CO leaks can happen in any home or enclosed space, at any time. It is one of the bitter ironies of our modern age that the practices and products we use to make our lives more comfortable, often pose a potential risk to our basic health and safety. We go to great lengths to insulate our homes in an effort to increase energy and heating efficiency but, while making our dwellings cosier, we are also making it difficult for fresh air to enter and for carbon monoxide to be vented properly. There is no law In Ireland for domestic dwellings in relation to carbon monoxide.

Symptoms of CO poisoning are similar to those of cold or flu. They include headache, feeling sick, tiredness, and dizziness. Because of the similarity of the symptoms to other conditions, carbon monoxide poisoning is often missed.

Carbon Monoxide alarms can be used to provide a warning in the event of a dangerous build-up of CO but they are no substitute for regular inspection and maintenance of appliances, vents, flues and chimneys.

The Hughes family have launched a personal campaign for legislation surrounding carbon monoxide alarms. They want regulations put in place that will make fixed carbon monoxide alarms compulsory in buildings and believe people should be made as aware of them as they are of smoke alarms.

You can protect your home from the dangers of this deadly gas by taking preventive measures and by learning to recognise the symptoms of carbon monoxide poisoning. Click here to find out more.

Source:  Tribune News and Carbon Monoxide.

Still Counting…

The total number of road deaths for 2008 has now reached 276.  That’s one more since yesterday.

A man was killed in a single-vehicle crash in Co. Louth yesterday evening.  He was the driver of a car that went off the road at about 6.10pm.  Gardaí are appealing for witnesses.

The circumstances of this man’s death are not yet known but my heart goes out to his family and friends. And sadly, this latest death on the roads is unlikely to be the last before the year is out.

Don’t invite a tragedy of this nature onto your doorstep. If you plan on drinking tonight, please leave the car behind.

Safe driving and a HAPPY NEW YEAR!

NEW YEAR’S DAY UPDATE:  Still counting… 😦

Three teenage boys aged 14, 16, and 17 have been killed in a car crash near Nenagh in Co Tipperary. Two other teenagers, a young man and woman, were seriously injured. The five teenagers were travelling in a car at around 7.30pm last night at Kilboy near Nenagh. Gardaí say the crash happened when the car left the road, mounted a ditch and hit a tree.

Transport Minister Noel Dempsey described the deaths as a terrible tragedy. Mr Dempsey appealed for all road users to continue the effort to reduce road deaths.

Be Drink Aware

A total of 275 people have died so far this year on Irish roads. Last year, 38 people lost their lives on our roads during the month of December, with 18 people killed or seriously injured over the Christmas period alone. The Road Safety Authority’s (RSA) campaign to improve safety on our roads, appears to be working as today’s figures represent a 20 per cent reduction (63 fewer road deaths) compared to this day last year. But the year is not over yet!

“It’s not just those seriously injured or killed on our roads whose lives are changed forever in a crash. Everyone crashes. The devastating consequences are like shock waves that affect family, relatives, friends, work colleagues and whole communities.”

This is the message contained in a new series of TV adverts as part of the RSA’s ‘Crashed Lives’ campaign.These new adverts featuring true-life stories of road tragedy, are being screened until the end of January but can also be viewed on www.rsa.ie

Gardaí have also appealed to all motorists to slow down, to keep to the speed limits and “observe personal responsibility” in their driving behaviour to protect their own lives, their passengers and all other road users.

Please, please be drink aware this New Year and don’t drink and drive. Remember, just one drink impairs driving. Don’t take that chance. Plan ahead. Leave the keys at home and get a taxi, minibus, public transport or take turns to designate a driver. After all, who wants to become just another statistic?

A Better Place

I knew the moment I walked into the dementia unit at the nursing home that something had changed. My mother was up and dressed and sitting in her wheelchair beside the window. I settled down beside her to chat and it was only then that I realised what was different… one of the long term residents was missing and her possessions were all neatly piled on top of her bed. Poor Hannah* had died during the night.

The other residents of the unit were all sitting staring into space as per normal and while they appeared oblivious to the fact that one of their own was no more, a sombre mood was palpable. Looking at them sitting in silence, I found it hard not to ponder over who’s turn it will be next… for that is the reality of this unit.

Alzheimer patients slowly fade away, it’s like a living death as bit by bit they withdraw from the world. The staff of this unit are very supportive of the families. We are like one big family who are on a difficult journey together and everyone supports one another. When a bereavement occurs, it affects everyone in the unit.

When Hannah’s family arrived to collect her belongings this afternoon, the sense of togetherness was powerful. We all hugged and shed a few tears and remembered the good times together. We’ve come to know each other well over the years and today’s farewell was a reminder that one day my turn will also come, to say goodbye.

My mother is one of the few residents in this unit that can still hold a conversation although she has great difficulty processing her thoughts. She loves to listen to the staff chatting as they work and will occasionally chip in with her penny’s worth.

Today, when I was discussing Hannah’s demise with the staff, my mother suddenly joined in and asked “well, is she better yet“?

I looked at her and smiled. “Hannah’s in a better place now, Mum, don’t you worry” and she smiled back at me happily.

Rest in Peace, Hannah.

* denotes a name change.

Design and Dignity

I attended a public lecture in Dublin last night as part of the Hospice friendly Hospitals (HfH) programme. The subject matter was ‘Design and Dignity’ the case for renewing our hospitals. The Irish Hospice Foundation has launched a unique national programme to mainstream hospice principles in all areas of hospital practice relating to care for the dying and bereaved. The lecture while enlightening, succeeded in emphasising the major deficiencies that exist in Irish hospitals but it was good to hear that attitudes are changing.

Professor Roger Ulrich, Director of Centre for Health Systems and Design in Texas, delivered a long lecture outlining the evidence based design principles that should be incorporated into all future hospital developments. Steps such as improving visibility of patients, providing single bed rooms, reducing noise levels, and introducing nature and art to the hospital environment, have all been shown to reduce stress for the patient. This is all very laudable stuff but it seemed a million miles away from the reality of the Irish Health Service where patients consider themselves lucky to even get a hospital bed and where cross-infection is a major problem due to overcrowding. Janette Byrne, spokesperson for ‘Patients Together‘ took to the floor and told the audience that what Prof Ulrich was talking about was “just a dream for Irish patients.” Janette, who is herself recovering from cancer, stated “I live more in fear of the Health Service than I do of my cancer” and for me, that really said it all last night.

We have a long way to go to make our hospitals more user friendly in this country. Irish hospitals are a very long way off meeting the needs of patients, families and staff in relation to dying, death and bereavement. The HfH programme aims to change the culture of care in our hospitals so that people can die with dignity. This programme is not about blaming and shaming, it is a challenge to us all to ensure that a better service will be provided. The chairman of the night, Gabriel Byrne, challenged us all to “imagine” a future where our hospitals would provide dignity in dying, and to “have hope.”

Blog Post of the Month

The Irish Blog Awards under the able leadership of Damien Mulley, have come up with another great idea.

“As a way of keeping interest going in the Blog Awards, there will be a “Blog Post of the Month” awarded to an Irish Blogger/Group of Bloggers who has/have written what the judges deem the best post that month.”

And here is my nomination for this award:

I have no hesitation whatsoever in nominating Grannymar for her post The light went out.

This post quite simply blew me away. In fact, judging by the comments, everyone who’s read it was blown away. It touched the hearts of all, young and old and indeed many of us were reduced to tears.

Grannymar wrote this post on the tenth anniversary of the death of her husband, Jack. It is a beautiful tribute written with great courage, wisdom, honesty, grace and enormous love.

By writing about her loss, Grannymar has overcome the taboo surrounding death and dying and I’ve no doubt that her words will help to ease the journey of others through bereavement. She also deals brilliantly with the thorny subject of the insensitivity shown by some people on meeting a bereaved person. She reminds us to be careful of what we say as ill-chosen words can be very hurtful when emotions are raw. But most of all, Grannymar illustrates beautifully how the human spirit can overcome adversity and begin to find joy in life once more. She is truly inspirational and her daughter, Elly can rightly be very proud of her.

I highly recommend you pop over to Grannymar’s to share in this uplifting post but don’t forget to bring some tissues. It’s moving stuff!

This post truly deserves to win a Blog Post of the Month Award.

A Long Wait

So that’s it! My grumble of last week has already become a reality. The HSE cutbacks are in full swing. One large ward at the public nursing home where my parents reside, has now officially been closed down. Once enough beds have been freed-up (which only occurs when another resident dies) to accommodate the residents from this ward, there will be 20 less long stay beds in the system. As well as this, all further placements for long term care at the nursing home, have been suspended until further notice.

It’s inevitable that this action will cause a negative knock-on effect on public health in the area served by this nursing home. People who are struggling to cope at home with a relative suffering from dementia (who needs round the clock care), are now going to have to wait even longer for help to arrive. The HSE has just cruelly lengthened the queue for long-term beds. If you have an elderly relative in hospital who’s ready to be discharged to a step-down bed in a local nursing home, then their wait in hospital has just got longer. These patients are often unfairly referred to as bed-blockers because of the log jam caused when acute hospital beds are used for long term care. This blockage of acute beds impacts on A&E services where waiting times on trolleys will inevitably increase thereby causing further chaos in emergency departments. Waiting lists for elective surgery will also get longer and operations will be cancelled because of the pressure put on bed allocation.

These delays are all a direct result of the HSE’s decision to restrict funding to one nursing home. Once again, we have no joined-up thinking coming from the HSE. If this action is replicated around the country which no doubt is the plan, then I fear the consequences. Morale in the health service has already been eroded by cutbacks across the service. This latest action from the HSE is enough to make anyone despair.

Help! I think I feel another health crisis coming on.

Emotional Storm

I watched a television programme recently about Irish patients with cancer. Any journey with cancer is an emotional roller coaster and this programme was no exception. My emotions were completely raw by the time it was over. One particular scene strongly resonated with me and brought back a memory I’d completely forgotten about.

The programme did not make for easy viewing. If you had recently been diagnosed with cancer or had suffered a bereavement, I would imagine it must have been very difficult to watch. We were not spared the stark reality of cancer. One fine lady with a wonderfully positive outlook on life, was given the news that she had advanced terminal cancer which was inoperable. She amazed me in the way she took this terrible news totally in her stride. She died a few short months later. We watched another elderly man who had been diagnosed with rectal cancer, undergo pre-operative radiotherapy and chemotherapy to shrink the tumour before surgery could proceed. Thankfully in his case, his operation was totally successful and no further treatment was required. It was his return home that resonated with me. As I watched him sit down in his favourite armchair while his wife went to put the kettle on, I witnessed him experience the realisation of how good it felt to be finally safely home.

When I returned by air last year following complex surgery in the UK, I will never forget the emotional storm which took me completely by surprise as the wheels of the plane touched down. I’m not particularly patriotic about my country of birth but on this occasion I was never so glad to be back in Ireland. In preparation for the surgery, I had put meticulous plans in place so that life would run as smoothly as possible during my absence from home. Any thoughts on the experience that lay ahead never went further than hoping for a successful outcome to the surgery. It was a particularly risky operation but all went well thanks to the expertise of the surgeon involved. My post-op stay in the NHS hospital also went smoothly and before I knew it, the day arrived when I had to make the long journey home. Unfortunately, I became unwell on the way from the hospital to the airport and had to be wheelchair boarded on to the plane. This experience taught me a great deal about the difficulties faced by disabled people in dealing with the ignorance of those lucky enough to be able bodied. I found the flight home exhausting and it was a relief to see the night-time landing lights come into view. As the plane touched down, I was overcome with emotion and burst into tears. I think at that moment I had the same realisation that the elderly man with cancer had experienced. I’d been able to plan ahead for most eventualities but the one thing I hadn’t contemplated, was the enormity of the relief to have survived the ordeal. I can’t tell you how good it felt to be home.

Dementia Happens

Old age has no respect for class, creed, fame or fortune. It’s an inevitable process… that is… presuming you get to survive that long.

By 2030, almost a million people in Ireland will be over 65 and the older you get, the more likely you are to suffer from dementia. There are approximately 38,000 people living with dementia in Ireland today.

There is no immediate hope of a cure for Alzheimer’s disease and with Ireland’s ageing demographics, it makes sense to plan ahead for the needs of an ageing society. A new study has found that people with dementia in residential care need to feel safe, secure, occupied, at home and connected to their former lives. Sadly, for the majority of the 7,000 dementia patients in residential care today, very few actually benefit from specialised dementia units.

My 80 year old mother has been in full-time care since 2004. She is wheelchair bound due to severe osteoporosis and also suffers from an unusual presentation of dementia. She is totally dependent on others for her everyday needs. For her first two years in the nursing home, my mum was terribly unsettled and became very depressed by her increasing dependency on others. Her dementia left her unable to follow simple instructions and she had frequent falls when left alone. The family were advised that she would be safer if moved to the dementia unit within the home where she could be constantly supervised. We agreed to this plan and shortly afterwards, she moved into the secure unit where she settled in very well. The care is fantastic there but the conditions are far from ideal.

This dementia unit is a locked unit for women only, with it’s own dedicated and very caring staff. It is basically one long, narrow, open-plan room where eleven women are living out their final days in horribly cramped conditions. They have to eat here, sleep here, are washed and toileted here, entertained and most likely will die here too. This poorly ventilated, overcrowded room is their home. Personal space consists of a bed, a bedside locker with tiny wardrobe attached and enough room for a chair beside the bed but nothing else. The unit has two small toilets neither of which are wheelchair accessible so only the few who are mobile, can use them. The residents in wheelchairs must use commodes with the curtains drawn around their beds for limited privacy. Some of the residents are bed-bound and are doubly incontinent. Meals are served up in this environment at two small tables at the end of the room and most of the patients must wait their turn to be spoon fed by the staff. The only form of entertainment is a television and a DVD player which were donated by the family of a deceased patient. A CD player was recently purchased by the ward manager so that the ladies can enjoy calming background music with their old-time favourites played over and over again – not that anyone would notice. There are many different levels of dementia in the room. Some of the patients have withdrawn from the world and just lie or sit staring into the distance all day, every day. Others are agitated or aggressive and have to be carefully managed so that they do not upset the other patients.

Dementia is not a pretty disease. There is little or no communication between the residents of this unit. This fact nearly broke my heart when my mum first moved in as I felt she was being denied a basic right to enjoy the pleasure of interaction and would deteriorate rapidly as a result. To give the staff credit where credit is due, they were quick to recognise this problem and they go to great lengths to chat with her as they go about their duties. I must add here that the staff are wonderful and I have huge admiration for the work they do in very difficult conditions. They look after all the patients with great love and compassion and I know my mum is very lucky to be in such good care. I regard the staff as part of the family these days – we work together as a team through thick and thin.

The world of dementia is a frightening and bewildering place for sufferers. My mother is safe and secure in her present surroundings but her environment leaves a lot to be desired. It does not resonate of home and it is poorly adapted to compensate for the disability of dementia. How would you like to end your days in a shared room with minimal privacy or dignity afforded? We need to take a more holistic approach to dementia by providing social, psychological and environmental supports and not by just throwing drugs at it. Surely, with the booming economy we live in today, this vulnerable section of society deserves better?